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Top 3 Factors in Knee Osteoarthritis

Let’s break a habit first. 


Please remove the phrases ‘wear & tear’ as well as ‘bone on bone’ from your mind. (I am not even going to include a photo, let’s just purge it from our minds now.) Reason: These two phrases give a perceived level of danger each time we hear, say, or think about them. This alone can create more issues, which we will talk about in a moment. 


Looking at osteoarthritis, of the 528 million people living with OA, 73% are over the age of 55 and 60% of people with osteoarthritis are female. Those are the numbers, and with the current living standards and aging population those numbers are only increasing. BUT know this: OA is not inevitable as we age, nor is it the end of your knee health.


This article is written from the latest research that comes out of the NOI Group in Australia. They have put together an amazing book called Epiphaknee: A Modern Approach to Knee Osteoarthritis’ and the following can be applied to all osteoarthritis, not just the knees, though the knee is the most frequently affected joint. 


Let’s cover the basics! 


First, when looking at the treatment of osteoarthritis we need to have 3 ingredients. One: Increase our activity. Yep, movement of the body (not an easy thing to do when you are in pain). Two: Increase our knowledge. The more we know, the better decisions we can make. This can be daunting, there is so much information out there! Last but certainly not least, we need to lower the inflammation in our body. 

Before we continue reading, if you think you’ve tried everything, or you don’t have the energy to learn more. I fully understand. It takes a certain amount of motivation to work on this. Sometimes it feels easier to just let someone else do it for you. There is so much information thrown at us through Google, social media, and more. Overload of information can cause us to freeze, and when you are experiencing pain every day, overload happens easily. 

So, I am asking you to stay with me for a bit. Learn 3 things today and I will help you find your starting point. One step at a time. 


Let’s look at the last point first. We are all familiar with swelling when we have an injury. This swelling is a good thing, it helps bring in all the right cells to begin repairing the area. This type of swelling should be temporary and as the injury heals, the swelling dissipates. If you can imagine your nervous system perceiving anxiety/worry/stress at the same level of danger as an injury (like a sprained ankle) but there is no real tissue damage, it might send out inflammation through the body to find and heal what is sensed as dangerous. But it doesn’t really find anything significant. Then it might repeat this, day after day, contributing to what is known as systemic inflammation. This is what happens when you constantly hear/say/think that your knee is bone moving on bone, or wearing out. Osteoarthritis is a process of systemic inflammation. The good news is that this process can be changed. Just like chronic pain, this inflammation can be triggered by stress, anxiety, overload, relationship conflict, worry, etc. So we need to work at creating better balance. Easier said than done sometimes. But we all need to start somewhere.


There are a few other factors that you should be aware of that contribute to inflammation as well. One is health conditions such as diabetes, infections, asthma, and heart conditions. Another is the amount of fat we have on our bodies. But here is the deal. No, it isn’t the weight of it that is creating the knee pain (though the ‘wear & tear’ and ‘bone on bone’ phrases would have us believe differently). If it were the weight, then our hands would not be as affected by osteoarthritis as they are. 


Look at it this way: fat stores in the body release substances that signal the immune system to increase inflammation. Things like a high sugar intake, overeating at a meal, drinking alcohol, and smoking cigarettes; all increase inflammation in your body. So the more fat we store on our body the more inflammation will affect us IF we have those poor habits of consuming pro-inflammation things. 


That is a loaded concept. But I don’t want you to see it as having to lose weight. I want you to see it as making healthier choices, lowering the factors that can cause added inflammation, and with a sustainable activity level you will be moving toward better habits and less pain, and this may just shrink some of those fat stores in the body. The bottom line is that we can work on building an achievable plan that is doable without the overwhelming goal of ‘losing weight’.


So, apart from decreasing the contributing factors of pro-inflammation in the body (reducing sugar intake, alcohol, overeating, smoking), we can also increase the amount of anti-inflammation foods and habits. Again, don’t over do it. Find the balance that you can sustain and manage right now. And it is never a perfect path. Drop that idea right now. At the end of this article you’ll find 3 tips to help you start on building your anti-inflammation path.


Next topic… the knowledge factor. Since you are still reading, you are doing great! I’ll be honest though, sometimes there is too much information and it leads us to freeze and not do anything at all. So, one step at a time. Just be aware of what habits you have that contribute to inflammation. Write down (yes, write them down, don’t just think about them) three things right now. Just one small step is a step in the right direction. Don’t jump into the deep end and feel like you will only be successful if you change everything right now, that is a sure path to frustration, overload, and failure. Pick one thing. Maybe one less glass of wine tonight. Maybe create a habit of a healthier breakfast, or just less sugar in your coffee. 


Last but not least, activity levels. We need to find the sweet spot. Too much activity or too little activity for us isn’t beneficial. Best place to start? Walking. Head out for a 10 minute walk. Start slow but by the 5 min mark find a pace that has you breathing a little more, at a level that would challenge you to carry on a full conversation. Then, once you become comfortable with that level, adjust the complexity. Maybe walk faster, for a longer time period, add in a staircase, stop at a bench and add in some squat/sitting movement. The list is endless but always try and find/add things that you like doing. It makes it easier.



You’ve read about increasing our activity and doing that slowly. We've talked about taking a look at the prevalance of pro-inflammatory activities (sugar, smoking, alcohol, overeating) in our daily lives. And we are still learning! Let’s look at 3 more: 


  1. Sleep. Yep, this is huge. If you need help, please seek out a health professional, and check out the post I wrote about sleep

  2. Head out into nature. Breathe the fresh air, listen to the birds, stare off into space, even hug a big old tree. Nature helps so much

  3. Build healthy social support. This can boost your immune system and help you laugh. Friends and family that you enjoy spending time with are key. 

So many places to start, which one resonated with you the most? Start there. Don’t end up freezing and not taking any action. I am here to help. We can work together to build your first few steps, but the work is up to you. Start small, take a breath, and live better.


Of course there is always a little more info to learn, get the book! It is an amazing resource and will lead you through building your path back to wellness. And if you are looking for even more guidance, let’s chat!

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